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[心律失常型心肌炎患者的诊断与治疗方法]

[Diagnostic and therapeutic approach to myocarditis patients presenting with arrhythmias].

作者信息

Peretto Giovanni, Sala Simone, Della Bella Paolo

机构信息

U.O. Elettrofisiologia Cardiaca ed Aritmologia Clinica, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milano.

出版信息

G Ital Cardiol (Rome). 2020 Mar;21(3):187-194. doi: 10.1714/3306.32767.

Abstract

Myocarditis is a complex inflammatory disease of the myocardium, occurring secondary to viral infections or autoimmune mechanisms in most cases. Among its multiple clinical manifestations, arrhythmias are often underdiagnosed, in spite of their important prognostic value. In particular, ventricular arrhythmias complicating either active or previous myocarditis, are a significant cause of sudden cardiac death, especially in young people. Because of the absence of clinical trials specifically addressing this topic, nowadays updated international guidelines report extremely generic recommendations about optimal clinical management of patients with arrhythmic myocarditis. This review aims at both (i) showing the state of the art about patients with myocarditis and arrhythmias (ventricular arrhythmias in particular); and (ii) suggesting optimal diagnostic and therapeutic strategies for these patients, based on the experience of a high-volume referral center for arrhythmic myocarditis and ventricular arrhythmia management.

摘要

心肌炎是一种复杂的心肌炎症性疾病,多数情况下继发于病毒感染或自身免疫机制。在其多种临床表现中,心律失常尽管具有重要的预后价值,但常常诊断不足。特别是,并发活动性或既往心肌炎的室性心律失常是心源性猝死的重要原因,尤其在年轻人中。由于缺乏专门针对该主题的临床试验,目前更新的国际指南对心律失常性心肌炎患者的最佳临床管理给出的建议极为笼统。本综述旨在:(i)展示心肌炎合并心律失常(尤其是室性心律失常)患者的最新研究现状;(ii)基于一家大容量心律失常性心肌炎和室性心律失常管理转诊中心的经验,为这些患者提出最佳诊断和治疗策略。

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